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| Trastuzumab, not lapatinib, has therapeutic effects on Chinese patients with HER2-positive cholangiocarcinoma |
| Hai-Bo Mou a,*, Wen-Dong Li b, Yan-Jun Shen b, Jun-Ping Shi c, Xiao-Di Guo b, Ming Yao c, Kai Wang c,d, Ting Zhang e |
a Department of Medical Oncology, Shulan (Hangzhou) Hospital, Hangzhou, China
b Department of Medical Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
c OrigiMed, Shanghai, China
d Shulan (Hangzhou) Hospital, Hangzhou, China
e Department of Bone marrow, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
∗Corresponding author.
E-mail address: mouhaibo@zju.edu.cn (H.-B. Mou)
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Abstract As a relatively uncommon orphan tumor with high mortality, biliary tract cancer (BTC) presents an aggressive course and heterogeneous clinical features [1] . BTC patients present with advanced manifestations [2] . Unfortunately, there has been little progress in the management of BTC. Most patients have inoperable lesions and must receive palliative therapy. Gemcitabine-based chemotherapy has been the only widely accepted first-line treatment for advanced BTC [3] . Nevertheless, BTCs are often refractory to chemotherapeutic regimens, leading to a poor clinical outcome in these patients. Recently, with the rapid development of next generation sequencing (NGS) technologies, some actionable mutations such as those in IDH1, FGFR2, BRAF, HER2 genes, and unique molecular subsets in BTCs have been identified [4] , and related targeted therapy against actionable mutations has been introduced into clinical practice as a promising therapeutic strategy [5] . The HER2 (also known as ERBB2 ) gene aberration has been recognized as an oncogenic driver and potential target in some human cancers, including breast cancer, lung cancer, and colorectal cancer [6] . To date, it is still an open question whether HER2 gene alterations are clinically relevant in BTC management [7] . Here, we describe a unique case report of two metastatic cholangiocarcinoma patients with different HER2 gene aberrations who had received anti-HER2 targeted therapy but presented significantly different responses, suggesting the importance of individualized medicine for the management of BTC patients, even those with similar mutation profiles.
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2018, Vol. 17 
